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Multiple Myeloma Treatment

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11 Table 2. Diagnostic Criteria for Active Multiple Myeloma 2014 IMWG Criteria • Clonal bone marrow plasma cells ≥10% or biopsy-proven bone or extramedullary plasmacytoma • Any one or more of the following myeloma-defining events (attributed to the plasma cells) ▶ Hypercalcemia (greater than upper limit of normal) ▶ Renal insufficiency: Serum creatinine >2 g/dL or creatinine clearance <40 ml/min ▶ Anemia: Hemoglobin <10 gm/dL or >2 gm/dL below lower limit of normal ▶ Bone lesions: one or more osteolytic lesions (as demonstrated on imaging studies) NEW Additional Criteria • Involved/uninvolved serum free light chains ratio ≥100, and the involved serum free light chain level ≥100 mg/dL • Clonal bone marrow plasma cells ≥60% • Two or more focal lesions based on MRI studies of the skeleton Note: Adapted with permission from Rajkumar 2014. Table 3. Revised International Staging System (R-ISS) • Stage I: ISS Stage I (β2-M <3.5 mg/L and serum albumin ≥3.5 g/dL) AND normal LDH, no abnormal FISH • Stage II: Neither Stage 1 or Stage III • Stage III: β2-M >5.5 mg/L AND elevated serum LDH, or abnormal FISH: presence of t(4, 14), t(14, 20), or 17p deletion Note: Adapted with permission from Palumbo 2015

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